As a risk manager, I stress the importance of documenting all clinical conversations with patients and their family members or caregivers. Relatedly, I was recently asked how to document a patient's nonverbal communication, such as eye rolling.

Posted in Risk Management on Monday, August 20, 2018

Some patients will quickly advise you they will not comply with your treatment recommendations. These are relatively straightforward situations to deal with. The patient’s statement of noncompliance can be documented by using quotation marks. Moreover, the patient’s upfront declaration gives you an opportunity to:

• Delve into his or her reasoning
• Educate the patient about the risks or benefits of not complying
• Discuss an alternative plan with which the patient might comply
• Document the entire interaction

It is more difficult to address a patient’s nonverbal signals. Nonverbal communication comes in many forms. It can be displayed through body language, facial expression and gestures. We demonstrate nonverbal actions constantly, as they support our verbal communication. 

The patient may not be aware they are sending out a nonverbal message. Therefore, it is important to confirm that you are receiving the correct nonverbal message. 

So, for a patient who rolls his or her eyes at your recommendations, I suggest you:

• Acknowledge that you sense some reluctance to adhere to the treatment plan 
• Ask open-ended questions to try and determine what is holding the patient back, both from complying and for being forthcoming about his or her concerns 
• Reinforce your willingness to talk further about any issue of concern 

Essentially, reassure patients and encourage them to talk about their concerns. This will help improve compliance with the treatment plan, leading to a more open and honest relationship between you and the patient. 

If you have questions about risky patient situations, such as patients who display negative nonverbal communication, please contact our Claims Advice Hotline.